Serum Calprotectin Levels Linked to Subclinical Carotid Atherosclerosis in Patients With Psoriatic Arthritis

In patients with psoriatic arthritis (PsA), serum calprotectin levels are associated with the presence of carotid plaques, according to a study published in Frontiers in Immunology.¹

“In PsA patients, serum calprotectin level was independently associated with the presence of carotid plaques, probably involving platelet and endothelial cells activation,” Isaac Cheng, PhD, of The Chinese University of Hong Kong in Shatin, China, and colleagues, wrote. “Moreover, subclinical carotid atherosclerosis was associated with the inflammatory burden (as reflected by the disease duration) in these patients.”

While the association between PsA and increased cardiovascular (CV) disease risk is well established, only limited data is available on the underlying mechanisms.

This cross-sectional study included 78patients (52.6% male, mean age 52 years) with PsA but without CV disease. Calprotectin levels in serum were quantified and high-resolution ultrasound was used to determine carotid intima-media thickness and the presence of plaque.

Of the patients, 37.2% had carotid plaques. Serum calprotectin level was significantly higher in the group with carotid plaques compared with those without carotid plaques (721.3 ng/ml vs 564.6 ng/ml, P = 0.005). Serum calprotectin level correlated with PsA disease duration and mean carotid intima-media thickness.

Least absolute shrinkage and selection operator regression was performed to screen out 19 predictive variables including age, gender, traditional CV risk factors, medication use, clinical features and disease activity. Ln-calprotectin (OR: 3.38, 95% CI [1.37, 9.47]; P = 0.026) and PsA disease duration (1.09, 95% CI [1.01, 1.18]; P = 0.013) were statistically significant in predicting carotid plaque.

Investigators developed a nomogram for discriminating the presence of carotid plaque, which they said was an “easy reference for clinical practice, with good accuracy, sensitivity and specificity (AUC 0.744, sensitivity 65%, specificity 79%).” They concluded that “serum calprotectin level may be a useful biomarker associated with a high inflammatory burden and the presence of subclinical carotid atherosclerosis in patients with PsA.”

A limitation of the study was that most of the patients had low disease activity, thus the results may not be applicable to patients with moderate or high disease activity.

Reference:

Cheng IT, Meng H, Li M, et al. Serum Calprotectin Level Is Independently Associated With Carotid Plaque Presence in Patients With Psoriatic Arthritis. Front Med (Lausanne). 2022;9:932696. Published 2022 Jul 8. doi:10.3389/fmed.2022.932696